SUPER "AIDS"

SUPER "AIDS"

"Super AIDS" is an informal term used by some for a strain of the human immunodeficiency virus that arose in New York City in 2005.
The phrase "Super AIDS" is not used in formal contexts, but it was used in the South Park episode The Death of Eric Cartman

Typically, the "wild" type of HIV (the strain of HIV found in individuals not treated with Antiretroviral drugs) is much more effective at attacking the human immune system than the types that evolve in the presence of antiretroviral drugs. Thus, by changing the selection pressure (from being infection driven to being drug-avoidance driven) retroviral drug treatment causes HIV to evolve to a more innocuous form, less efficient at infecting T-cells.

Super AIDS, however, was a strain that was not only resistant to anti-retroviral drugs, but it was more effective than "wild" HIV at infecting T-cells.

The strain retained vulnerability to enfuvirtide.

WORLD AIDS DAY

WORLD AIDS DAY

World AIDS Day, observed December 1 each year, is dedicated to raising awareness of the AIDS pandemic caused by the spread of HIV infection. It is common to hold memorials to honor persons who have died from HIV/AIDS on this day. Government and health officials also observe the event, often with speeches or forums on the AIDS topics. Since 1995, the President of the United States has made an official proclamation on World AIDS Day. Governments of other nations have followed suit and issued similar announcements.

AIDS has killed more than 25 million people between 1981 and 2007, and an estimated 33 million people worldwide live with HIV as of 2007, making it one of the most destructive epidemics in recorded history. Despite recent, improved access to antiretroviral treatment and care in many regions of the world, the AIDS epidemic claimed an estimated 2 million lives in 2007, of which about 270,000 were children.

THEME
From its inception until 2004, UNAIDS spearheaded the World AIDS Day campaign, choosing annual themes in consultation with other global health organizations.

As of 2008, each year's World AIDS Day theme is chosen by the World AIDS Campaign's Global Steering Committee after extensive consultation with people, organizations and government agencies involved in the prevention and treatment of HIV/AIDS. For each World AIDS Day from 2005 through 2010, the theme will be "Stop AIDS. Keep the Promise.", with a yearly sub-theme.This overarching theme is designed to encourage political leaders to keep their commitment to achieve universal access to HIV/AIDS prevention, treatment, care, and support by the year 2010.

This theme is not specific to World AIDS Day, but is used year-round in WAC's efforts to highlight HIV/AIDS awareness within the context of other major global events including the G8 Summit. World AIDS Campaign also conducts "in-country" campaigns throughout the world, like the Student Stop AIDS Campaign, an infection-awareness campaign targeting young people throughout the UK.

HOW TO PREVENT AIDS ??

HOW TO PREVENT AIDS ??

The three main transmission routes of HIV are sexual contact, exposure to infected body fluids or tissues, and from mother to fetus or child during perinatal period. It is possible to find HIV in the saliva, tears, and urine of infected individuals, but there are no recorded cases of infection by these secretions, and the risk of infection is negligible.

1. SAFE SEX (use condom)
During a sexual act, only male or female condoms can reduce the chances of infection with HIV and other STDs and the chances of becoming pregnant. The best evidence to date indicates that typical condom use reduces the risk of heterosexual HIV transmission by approximately 80% over the long-term, though the benefit is likely to be higher if condoms are used correctly on every occasion.

2. Exposure to infected body fluids
Health care workers can reduce exposure to HIV by employing precautions to reduce the risk of exposure to contaminated blood. These precautions include barriers such as gloves, masks, protective eyeware or shields, and gowns or aprons which prevent exposure of the skin or mucous membranes to blood borne pathogens. Frequent and thorough washing of the skin immediately after being contaminated with blood or other bodily fluids can reduce the chance of infection. Finally, sharp objects like needles, scalpels and glass, are carefully disposed of to prevent needlestick injuries with contaminated items. Since intravenous drug use is an important factor in HIV transmission in developed countries, harm reduction strategies such as needle-exchange programmes are used in attempts to reduce the infections caused by drug abuse.

3. Mother-to-child transmission (MTCT)
Current recommendations state that when replacement feeding is acceptable, feasible, affordable, sustainable and safe, HIV-infected mothers should avoid breast-feeding their infant. However, if this is not the case, exclusive breast-feeding is recommended during the first months of life and discontinued as soon as possible.

What is HIV ?

What is HIV ?
Human immunodeficiency virus (HIV) is a lentivirus (a member of the retrovirus family) that can lead to acquired immunodeficiency syndrome (AIDS), a condition in humans in which the immune system begins to fail, leading to life-threatening opportunistic infections. Previous names for the virus include human T-lymphotropic virus-III (HTLV-III), lymphadenopathy-associated virus (LAV), and AIDS-associated retrovirus (ARV).

How HIV Infect People ?
Infection with HIV occurs by the transfer of blood, semen, vaginal fluid, pre-ejaculate, or breast milk. Within these bodily fluids, HIV is present as both free virus particles and virus within infected immune cells. The four major routes of transmission are unprotected sexual intercourse, contaminated needles, breast milk, and transmission from an infected mother to her baby at birth (Vertical transmission). Screening of blood products for HIV has largely eliminated transmission through blood transfusions or infected blood products in the developed world.

In general if infected blood comes into contact with any open wound, HIV may be transmitted. This transmission route can account for infections in intravenous drug users, hemophiliacs and recipients of blood transfusions (though most transfusions are checked for HIV in the developed world) and blood products. It is also of concern for persons receiving medical care in regions where there is prevalent substandard hygiene in the use of injection equipment, such as the reuse of needles in Third World countries. Health care workers such as nurses, laboratory workers, and doctors have also been infected, although this occurs more rarely. People who give and receive tattoos, piercings, and scarification procedures can also be at risk of infection.

Since transmission of HIV by blood became known medical personnel are required to protect themselves from contact with blood by the use of Universal precautions.

Virus Transmission
* Mother to Child Transmission
The transmission of the virus from the mother to the child can occur in utero during pregnancy and intrapartum at childbirth. In the absence of treatment, the transmission rate between the mother and child is around 25 percent. However, where combination antiretroviral drug treatment and Cesarian section are available, this risk can be reduced to as low as one percent.
Breast feeding also presents a risk of infection for the baby.

* From Saliva, Tears & Urine
HIV has been found at low concentrations in the saliva, tears and urine of infected individuals, but there are no recorded cases of infection by these secretions and the potential risk of transmission is negligible.

HIV Treatment
There is currently no vaccine or cure for HIV or AIDS. The only known method of prevention is avoiding exposure to the virus. However, a course of antiretroviral treatment administered immediately after exposure, referred to as post-exposure prophylaxis, is believed to reduce the risk of infection if begun as quickly as possible. Current treatment for HIV infection consists of highly active antiretroviral therapy, or HAART. This has been highly beneficial to many HIV-infected individuals since its introduction in 1996, when the protease inhibitor-based HAART initially became available. Current HAART options are combinations (or "cocktails") consisting of at least three drugs belonging to at least two types, or "classes," of antiretroviral agents. Typically, these classes are two nucleoside analogue reverse transcriptase inhibitors (NARTIs or NRTIs) plus either a protease inhibitor or a non-nucleoside reverse transcriptase inhibitor (NNRTI). New classes of drugs such as Entry Inhibitors provide treatment options for patients who are infected with viruses already resistant to common therapies, although they are not widely available and not typically accessible in resource-limited settings. Because AIDS progression in children is more rapid and less predictable than in adults, particularly in young infants, more aggressive treatment is recommended for children than adults. In developed countries where HAART is available, doctors assess their patients thoroughly: measuring the viral load, how fast CD4 declines, and patient readiness. They then decide when to recommend starting treatment.

The Meaning Of AIDS

SYMPTOMS:
The symptoms of AIDS are primarily the result of conditions that do not normally develop in individuals with healthy immune systems. Most of these conditions are infections caused by bacteria, viruses, fungi and parasites that are normally controlled by the elements of the immune system that HIV damages.

Opportunistic infections are common in people with AIDS. HIV affects nearly every organ system.

People with AIDS also have an increased risk of developing various cancers such as Kaposi's sarcoma, cervical cancer and cancers of the immune system known as lymphomas. Additionally, people with AIDS often have systemic symptoms of infection like fevers, sweats (particularly at night), swollen glands, chills, weakness, and weight loss. The specific opportunistic infections that AIDS patients develop depend in part on the prevalence of these infections in the geographic area in which the patient lives.

MAIN CAUSE :

Sexual Relation

The majority of HIV infections are acquired through unprotected sexual relations between partners, one of whom has HIV. The primary mode of HIV infection worldwide is through sexual contact between members of the opposite sex.

During a sexual act, only male or female condoms can reduce the chances of infection with HIV and other STDs and the chances of becoming pregnant. The best evidence to date indicates that typical condom use reduces the risk of heterosexual HIV transmission by approximately 80% over the long-term, though the benefit is likely to be higher if condoms are used correctly on every occasion.

Sexual transmission occurs with the contact between sexual secretions of one person with the rectal, genital or oral mucous membranes of another. Unprotected receptive sexual acts are riskier than unprotected insertive sexual acts, and the risk for transmitting HIV through unprotected anal intercourse is greater than the risk from vaginal intercourse or oral sex.

However, oral sex is not entirely safe, as HIV can be transmitted through both insertive and receptive oral sex. Sexual assault greatly increases the risk of HIV transmission as protection is rarely employed and physical trauma to the vagina frequently occurs, facilitating the transmission of HIV.

Exposure to blood-borne pathogens

This transmission route is particularly relevant to intravenous drug users, hemophiliacs and recipients of blood transfusions and blood products. Sharing and reusing syringes contaminated with HIV-infected blood represents a major risk for infection with HIV.

Needle sharing is the cause of one third of all new HIV-infections in North America, China, and Eastern Europe. The risk of being infected with HIV from a single prick with a needle that has been used on an HIV-infected person is thought to be about 1 in 150. Post-exposure prophylaxis with anti-HIV drugs can further reduce this risk.

Perinatal transmission
The transmission of the virus from the mother to the child can occur in utero during the last weeks of pregnancy and at childbirth. In the absence of treatment, the transmission rate between a mother and her child during pregnancy, labor and delivery is 25%.

Misconceptions
A number of misconceptions have arisen surrounding HIV/AIDS. Three of the most common are that AIDS can spread through casual contact, that sexual intercourse with a virgin will cure AIDS, and that HIV can infect only homosexual men and drug users. Other misconceptions are that any act of anal intercourse between gay men can lead to AIDS infection, and that open discussion of homosexuality and HIV in schools will lead to increased rates of homosexuality and AIDS.

Ayurvedic Management of HIV/AIDS

At present, there is no scientifically proved cure for HIV /AIDS. Globally, the number of infected HIV /AIDS patients is increasing at an alarming rate; with a current estimate of 33.2 million people who are living with HIV 1. Hence, there is a dire need to search for a safe, effective and economical treatment for HIV /AIDS.

In a retrospective study in 55 patients, Ayurvedic treatment has proved to be very promising in the management of HIV/AIDS. Fifty-Five adult patients were given Ayurvedic treatment for HIV/AIDS, during the period from April 1999 to November 2004.Each patient had tested positive for HIV/AIDS on at least 2 different occasions. No patient was taking anti-retroviral drugs at the time of commencing Ayurvedic treatment. All patients were started on treatment after written, informed consent.

The Ayurvedic Herbal Combination ( AHC ) comprises of eleven different herbs in different dosage strengths, based upon their respective potencies, reported anti-viral and immunomodulatory properties, and their traditional usage according to Ayurvedic principles of medicine 2 -4 .The constituents of AHC with their respective dosages are as follows:-Terminalia arjuna: 250 mg. ;Zinziber officinale: 250 mg. ;Phyllanthus niruri :1 gm ;Glycyrrhiza glabra:1gm. ;Withania somnifera:1gm. ;Eclipta alba: 250mg. ;Centella asiatica: 250mg. ;Boerhavia diffusa: 250mg. ;Emblica officinalis: 250mg. ;Tinospora cordifolia: 250mg. ;Rubia cordifolia: 250mg. This AHC was dispensed in a combined dose of 5 gms. t.i.d., to be taken with water after meals. Aqueous herbal extracts of all the medicines were used, in tablet form.

All patients were advised to eat a well-balanced, nutritious diet. Therapeutic counseling sessions were conducted regularly to help the patients achieve mind relaxation, to modify their risk behavior , and to increase adherence and compliance to therapy.

All patients were followed up at monthly intervals. Detailed clinical examination was done at each visit and significant findings were recorded. In addition, in affording and willing patients, investigations like CBC, Hb, Liver and Renal functions, X-Ray of chest, Western Blot, CD4 count and Viral Load were done wherever possible. Other investigations were done, if required, for Opportunistic Infections (O.I.).All O.I. were promptly and aggressively treated with modern medicines. A close watch was kept for adverse reactions of the drugs.

Therapeutic outcome was assessed by overall clinical examination, change in Karnofsky score (assessment for overall well-being of patients), change in weight, occurrence and response to O.I., and change in CD4 and Viral Load values. Maximum number of patients was in the age ranging from 20 - 39 years (80 %). Of the total number of 55 patients, 39 were male (71 % ) and 16 were female (29 %), with the male: female ratio being 2.4: 1. There were 7 couples who took treatment together.

Of the 55 patients, 5 patients died, 42 patients took treatment for varying periods and then stopped treatment, while 8 patients continued treatment till the end of the study period. The 5 patients who died were critically ill at the time of presentation, and died mostly within the first two months of starting Ayurvedic treatment. The cause of death varied ; 1 patient died from cirrhosis of the liver, 3 died of extensive Pulmonary Tuberculosis (multi-drug resistant) and 1 died of a combination of Pulmonary Tuberculosis and demyelination disease of the brain.

In the 50 patients who were alive till the time of their last follow-up , there was an average weight-gain of 2.3 kgs.(range = - 4 to + 7.5 kgs), usually within the first 3 months. In those patients who took continuous treatment for more than 3 months, the Karnofsky score increased from an average of 75.9 at the commencement of treatment to 87.4 at the last follow-up. Almost all the patients had 1-3 O.I. at the time of presentation. Other than Tuberculosis, all the O.I. cleared up rapidly within the first 2 months of treatment.

Long-term administration of Ayurvedic medicines (upto 30 months) did not seem to have any major adverse effects. In fact, in a few patients, the tests for liver and renal function appeared to normalize further, with treatment. Haemoglobin readings gradually improved in those patients taking regular, prolonged treatment.The most striking effect of the Ayurvedic medicines was on the Viral Load and CD4 counts. Because of financial constraints, only 15 patients (27 % ) agreed to do either the Viral Load or the CD4 count, or both. In most patients, there was a definite and steady decrease in the Viral Load, and an increase in the CD4 cell counts.

Antiretroviral medicines are the mainstay in the modern treatment of HIV/AIDS. However, a plethora of side-effects, development of resistance to drugs and escalating treatment costs are serious concerns. In the absence of a definite cure for HIV/AIDS, Ayurvedic medicines may provide a useful alternative for long-term management of patients, since these medicines are economical and devoid of serious side-effects. However, scientific research is necessary to determine efficacy of these medicines. This retrospective study is one such effort to assess long-term therapeutic effects of an Ayurvedic Herbal Combination in the management of HIV /AIDS.

In this study, 4 patients died within the first 2 months of commencing treatment. Onset of therapeutic effect is slow with Ayurvedic medicines, and these patients probably could not benefit from Ayurvedic treatment. This emphasizes the need to start treatment as early as possible in immuno-compromised patients. The causes of death indicate that Tuberculosis and CNS involvement are major killers in HIV patients. Multi-drug resistance to Tuberculosis is also a major concern.

16 patients ( 29% ) did not come back after just one ( 11% ) or two ( 18% ) visits. The reasons cited were, a complete inability to pay for treatment, or a search for a ‘better’ or a ‘guarenteed cure’. Fortunately, perceptions have changed in the last few years. Even illiterate patients from the lower socio-economic strata are no longer asking for a ‘guarantee’ or a ‘cure’. ‘Long-term management with minimum expenses’ is a mantra being readily accepted by the HIV positive patient of today.

All the patients who took medicines regularly, had a high-protein diet and kept themselves busy, improved very well and put on weight. Even 2 to 3 years after stopping Ayurvedic treatment, most of the patients are doing very well, some inspite of very low CD4 counts. This is probably one of the biggest long-term advantages of taking Ayurvedic medicines for HIV /AIDS. However, patients with socio-economic difficulties and a lot of psychological pressure who could not have access to regular treatment, started losing weight after initially improving with treatment. A comprehensive management of each patient thus needs to address several issues relevant to each individual patient.

This study also brought forth some interesting results. One patient who subsequently died, had severe demyelinating disease of the brain (as diagnosed in a major hospital), and had lost most of his motor control and sensory senses, since several months. After being given Ayurvedic treatment for about 1 ½ months he became alert, and could speak clearly, albeit temporarily, for 1 week. Another patient with Nephrotic syndrome resulting in long-standing generalized oedema (2 years ) had complete regression of the oedema after 2 months of Ayurvedic treatment without any other treatment. One HIV positive patient with suspected malignancy of lung in the right upper lobe was steadily losing weight. After starting Ayurvedic treatment, he started putting on weight. Another patient with history suggestive of HIV Encephalopathy was semi-conscious at presentation. He was passively fed on liquid diet and a combination of both modern drugs and Ayurvedic treatment. This patient be!

came ambulatory within 2 weeks, and after 2 months of treatment he was faring well, even with a CD4 count of just 6.The above 4 instances indicate that the Ayurvedic medicines may have multi-faceted properties and need further evaluation.

Thus,the retrospective study of 55 HIV positive adult patients treated with an Ayurvedic Herbal combination from April 1999 to November 2004 proved the Ayurvedic medicines to be highly effective as anti-viral and immuno-stimulant,and safe on long-term use. A nutritious diet, Ayurvedic baseline therapy, timely allopathic treatment of Opportunistic Infections and regular counseling support appears to be an ideal combination in the management of HIV/ AIDS patients.